Clinicopathological And Thoracic Computed Tomography Imaging Features In Patients With Large Cell Neuroendocrine Carcinoma Of The Lung

Objective:To investigate the clinicopathological features and thoracic computed tomography(CT)imaging features of Large Cell Neuroendocrine Carcinoma of the Lung(LCNEC)and to raise awareness of the disease.Methods:Retrospective analysis of clinical features,pathological characteristics and thoracic computed tomography findings of 68 patients with LCNEC diagnosed by pathology in the First Affiliated Hospital of Medical College of Zhejiang University from March 2010 to October 2015.Results:Clinical features:of the 68 patients,61 cases were male(89.7%),7 cases were female(10.3%).age 42 to 83 years,mean age(64.0±7.8)years old.28 cases(41.2%)found in physical examination;cough happened in 21 cases(30.9%),sputum with blood or hemoptysis in 13 cases(19.1%).A history of smoking in 50 cases(73.5%),the average smoking index was 840,which accords with the severe smoking standard.Four tumor markers for lung cancer:carcinoembryonic antigen(CEA)was positive in 16 cases(23.5%).Thoracic computed tomography findings:thoracic CT showed nodules in 24 cases(35.3%),the other 44 cases(64.7%)showed masses,and the average diameter of the tumor was(4.1±2.1)cm;46 cases(67.6%)developed peripheral lung cancer,and 22 cases of central lung cancer;lobulation 47 cases(69.1%);well defined margin 38 cases(55.9%);the density of 44 cases(64.7%)were homogeneous;spiculated margin 20 cases(29.4%),13 cases(19.1%)the invasion approached to the pleura;7 cases(10.3%)developed obstructive pneumonia;5 cases(7.4%)developed cavity;2 case(2.9%)developed pleura effusion;and 2 case(2.9%)develop atelectasis;35 cases mediastinal lymph node enlargement(51.5%);Normal chest CT and enhanced scanning of chest were administrated in 37 cases.Among them,22 cases showed inhomogeneous enhancement(mainly mild and moderate enhancement).9 cases distant metastasis(13.2%).Conclusion:LCNEC often occurs in elderly men who smoke heavily,and the clinical symptoms lack specificity;four tumor markers positive for lung cancer are not common;thoracic CT findings have certain characteristics:peripheral,lobulation,well defined margin,mediastinal lymph node metastasis often occurs.